Background: Cytisine is a prospective pharmacological alternative for community pharmacy smoking cessation services. However, it has not yet been licensed because of a lack of efficacy and safety information in Thailand. Objective: The aim of this study was to evaluate the efficacy of cytisine in combination with community pharmacists’ counselling on smoking cessation in a community pharmacy in ThailandDesign. Setting, participants, and interventions: A double-blinded randomized placebo-controlled trials was carried out. Participants aged >18 years old who smoked >10 tobaccos/day were randomly assigned to receive cytisine or placebo and five sessions of counselling by a community pharmacist. The primary outcome was a continuous abstinence rate (CAR) at week 48. The CAR was also measured at weeks 2, 4, 12, and 24. Adverse events were monitored. Results: A total of 132 participants were included, with 67 receiving cytisine and 65 receiving a placebo. Approximately 95% of participants were male. The CARs were determined to be 14.93% and 6.15% for cytisine and placebo, respectively, at week 48. The relative risk (RR) was 2.41 (95% confidence interval (CI); 0.80–7.35, p = 0.102). The RRs for CAR at weeks 2, 4, 12, and 24 were 2.43, 2.91, 2.50, and 1.78, respectively. Only the RRs for weeks 2, 4, and 12 were statistically significant. Common and non-serious gastrointestinal and neurological adverse events were observed. Conclusion: Cytisine, when combined with community pharmacists’ counselling, did not statistically improve the CAR at week 48, although it did improve the CAR at weeks 2, 4, and 12. Adverse events of cytisine were common and non-serious (registration number: TCTR20180312001).

Shiftwork is related to an increased risk of several diseases, including gastric ulcers, myocardial infarction, and diabetes. Several shiftwork patterns are related to poor sleep quality, such as a quick returns or extended shifts. This study aimed to find the shiftwork patterns strongly associated with poor sleep quality amongst nurses. A cross-sectional analytical study was conducted among nurses working for at least one month. The sub-groups were the good sleep quality group (n = 150) and the poor sleep quality group (n = 472). Eligible participants were asked to complete a self-reported questionnaire comprising personal characteristics, job characteristics, shiftwork characteristics, and sleep quality. Factors associated with poor sleep quality were determined using logistic regression analysis. Two factors associated with poor sleep quality remained in the final model: viz., depression and backward rotational shift. The only independent factor for poor sleep quality was a backward rotational shift with an adjusted odds ratio (95% CI) of 1.946 (1.344, 2.871). In conclusion, compared with other shift patterns, backward shiftwork was the most significant factor associated with poor sleep quality and should be avoided.

Asthma affects over 260 million people globally, with significant health impacts. The Global Initiative for Asthma (GINA) 2024 report recommends inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) combinations, including fluticasone propionate/salmeterol (FP/SAL) and budesonide/formoterol (BUD/FOR), for maintenance treatment. Both combinations have demonstrated clinical benefits, with previous clinical trials and real-world studies showing comparable asthma control with FP/SAL and BUD/FOR. This United States (US)-based study compares the real-world effectiveness of FP/SAL and BUD/FOR on asthma control and treatment adherence. This retrospective cohort study analyzed data from the US Optum's Market Clarity database (July 1, 2010, to December 31, 2019), with integrated medical, pharmacy claims, and clinical electronic health records. Patients aged ≥18 years with asthma at GINA Steps 3-4, and ≥1 pharmacy claim for FP/SAL or BUD/FOR (index) were included. Patients on other ICS/LABA therapy ≥12 months prior to index were excluded. Inverse probability of treatment weighting adjusted for confounders. Outcomes were stratified by asthma severity. A total of 57,000 patients were included (FP/SAL: 28,639; BUD/FOR: 28,361). Baseline characteristics were balanced post-weighting. Asthma control was similar between cohorts, with no significant differences in Asthma Control Test scores or short-acting β₂-agonist fills during the 12-month period following the index. Treatment adherence, assessed using proportion of days covered (≥0.8), was higher in the FP/SAL cohort (5.4 %) versus the BUD/FOR cohort (4.4 %; p < 0.001). FP/SAL and BUD/FOR were similarly effective for asthma control in real-world settings, while FP/SAL was generally associated with greater medication adherence, a key factor for long-term control.